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General NPI Number Information
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NPI Number | 1831265537
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Entity Type | Individual
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Provider Name | DAVID ALAN BOOKSTAVER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 300 W HOSPITAL RD EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS
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City | FORT GORDON
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State | GA
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Zip | 30905-5741
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Country | US
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Telephone | 706-787-8104
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Fax | 706-787-2210
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Provider Business Mailing Address
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Address Line | 300 W HOSPITAL RD EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS
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City | FORT GORDON
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State | GA
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Zip | 30905-5741
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Country | US
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Telephone | 706-787-8104
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Fax | 706-787-2210
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 5539
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5539
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License Number State | SC
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